Art Breaks 2024

Please complete this form by 5pm on Friday 11th October 2024.

Project Art Works aims to provide the best possible environment for engagement. We use the following information to support each young persons creative journey. Please complete each section as fully as possible.

There is a suggested donation of £10 per family per session.

We will aim to be in contact by Friday 18th October 2024 to offer a session.

Question Title

* 1. Have you been to Art Breaks before?

Question Title

* 2. Would you like to inform us of any changes to the Consent Form completed on previous visits? (only applicable if you have been before)

Question Title

* 3. Participant Information

Question Title

* 4. Disability (if diagnosed)

Question Title

* 5. Please describe the difficulties the young person experiences (please complete as fully as possible)

Question Title

* 6. Can you tell us any other information that will help us to support the young person i.e. likes, dislikes, other?

Question Title

* 7. Sibling Information (who will be attending)

Question Title

* 8. Sibling: Disability (if diagnosed)

Question Title

* 9. Siblings: can you provide us with some information about their interests, painting, drawing, making etc.

Question Title

* 10. Parent /Carer Information

Question Title

* 11. Dates and times available for Art Breaks @ the Arches & Trinity Hall in Hastings.
Please indicate a first and second choice.

  First choice Second choice
Tuesday 29th October - 10.30am - 12.00pm
Tuesday 29th October - 1.30pm - 3.00pm
Wednesday 30th October - 10.30am - 12.00pm
Wednesday 30th October - 1.30pm - 3.00pm
Thursday 31st October - 10.30am - 12.00pm
Thursday 31st October - 1.30pm - 3.00pm

Question Title

* 12. If you have a particular restrictions around your availability please add a note below.

Question Title

* 13. Would you like to keep in touch and receive our newsletter?

T